Indian-origin Doctor Warns H-1B Fee Hike Will Harm U.S. Healthcare

(UNITED STATES) A sweeping hike in H-1B fees to $100,000 for new petitions has ignited alarm across the U.S. healthcare sector, with hospital leaders and doctors warning the change will push up costs, deepen staffing shortages, and weaken care in rural and underserved communities.

“The quality of care will decline, innovation and research will suffer,” said Mahesh Anantha, an Indian-origin interventional cardiologist in Arkansas who serves as a lifeline for surrounding communities.

The fee change, which remains in effect as of October 28, 2025, is already prompting warnings from professional associations and hospital systems that rely on immigrant physicians to cover critical gaps in coverage.

“We have heard from health systems who say this fee would be devastating,” said Dr. Bobby Mukkamala, president of the American Medical Association and the first Indian-origin doctor to hold that position.

His message echoes mounting concerns from smaller hospitals that say the charge will make it cost-prohibitive to sponsor international talent, risking cuts to services and longer wait times for patients who are already traveling long distances for specialist care.

Healthcare administrators and clinicians describe a clear line from the new price tag to real-world consequences: fewer job offers for foreign-trained physicians; delayed hiring that leaves ERs, ICUs, and outpatient clinics shorthanded; and lost research fellows whose work underpins clinical trials and patient safety advances. “filling critical gaps in care,” said Dr. Satheesh Kathula, president of the American Association of Physicians of Indian Origin, arguing that immigrant physicians complement, rather than displace, the U.S. workforce in areas where staffing is thin and recruitment is difficult.

The stakes are sharpened by long-standing shortages. The Association of American Medical Colleges projects a deficit of up to 86,000 physicians by 2036, a shortfall intensified by a growing, aging population with complex health needs. Rural counties, which already struggle to recruit cardiologists, psychiatrists, and anesthesiologists, depend heavily on international clinicians whose visas allow them to practice in communities that lack homegrown specialists. In Arkansas, Anantha’s cardiology practice handles emergency interventions for patients across multiple counties; he fears the new H-1B fees will deter hospitals in similar regions from hiring the next generation of specialists. He says the math is stark: for facilities with thin margins, one six-figure fee on top of recruitment costs, relocation, credentialing, and compliance can be the difference between filling a post and leaving it vacant.

Data on the role of immigrant physicians underscores the exposure. In fiscal year 2024, 16,937 H-1B petitions were for medicine and health occupations, representing 4.2% of total approved petitions, according to figures cited by stakeholders tracking the program. More than 70% of H-1B visas go to Indian nationals, many of whom work in healthcare settings as physicians, researchers, and allied health professionals. Those numbers translate into hospital rounds covered, rural clinics kept open, and research labs staffed. When those candidates drop out of recruitment pipelines because of the cost of sponsorship, the healthcare impact can be immediate: schedules stretch, waitlists grow, and patients wait longer for diagnosis and procedures.

Pressure for relief is building. The American Hospital Association has urged the administration to exempt healthcare personnel from the fee increase, arguing that frontline staffing and patient safety are at risk as hospitals weigh whether they can afford to petition for foreign-born physicians. Trade groups for community hospitals say they face the sharpest pinch. Unlike large academic centers, small and mid-sized facilities cannot spread visa costs across deep budgets or absorb sudden increases without paring back services. Hiring plans that previously included a mix of U.S.-trained and international doctors are being reworked, with recruiters reporting that some posts are going unadvertised due to cost.

The personal stakes are visible in the histories of families who built long careers serving U.S. patients. Geeta Minocha, a lawyer, public finance expert, and M.D. candidate at Stanford Medicine, has spoken about how Indian doctors have historically filled gaps in the U.S. system, recalling her grandfather, a cardiologist who immigrated in the 1970s and contributed to care in the Midwest. She and other trainees warn that the new fees could dull the edge of American healthcare innovation, because the same visa pathways that bring bedside clinicians also bring researchers whose grant-funded work advances treatments and patient outcomes.

Mukkamala’s warning lands in an ecosystem already stretched by pandemic burnout, rising demand, and uneven geographic distribution of services. Rural emergency departments that rely on a patchwork of locum tenens physicians and visa-sponsored hires face particular risk. Administrators say they will be forced into hard choices: thinning overnight coverage, reducing outpatient clinic hours, or delaying the launch of specialist programs—moves that ripple through local economies dependent on the hospital as a major employer. For critical access hospitals, where margins can swing on a handful of high-cost cases, a single unfilled specialist role can push patients to seek care hours away, with measurable effects on strokes, heart attacks, and maternal health outcomes.

Anantha’s fear that “innovation and research will suffer” reflects pressure beyond the bedside. Many immigrant physicians split their time between clinical care and study protocols, often in trials that require steady recruitment and careful monitoring to meet safety and efficacy benchmarks. If visa sponsorship dries up, department chairs say they could see delays in trials and setbacks in efforts to translate laboratory discoveries into treatments. Researchers also note that international fellows and residents bring skills in data analysis, imaging, and AI-assisted diagnostics that can boost productivity—a loss that cannot be easily backfilled when U.S. graduate pipelines are already constrained.

Supporters of exemptions point to the limited slice of overall H-1B usage that healthcare represents—4.2% in fiscal 2024—arguing that targeted relief would not upend broader visa policy. They also emphasize that immigrant physicians tend to accept postings in parts of the country that struggle to hire, particularly safety-net systems and remote counties, making the case that healthcare-specific adjustments would improve access for patients without displacing American graduates. Hospital leaders stress that any pause in recruitment will be felt quickly: onboarding a physician can take months for licensing and credentialing, so missing a hiring window can spill over into the following year’s schedule.

Some policymakers have floated carveouts for healthcare workers, and trade groups say talks are ongoing. As of October 28, 2025, however, the $100,000 fee for new H-1B petitions remains in place, with discussions continuing over potential exemptions for healthcare personnel. In the meantime, hospital legal teams are poring over budgets and staffing plans to decide whether to proceed with sponsorships already in motion or to freeze search efforts until there is clarity. Program directors report that graduates weighing offers now ask pointed questions about whether an employer will absorb the fees, spreading uncertainty across residency match cycles and fellowship placements.

Those pressures land hardest on communities with few alternatives. Rural healthcare systems that serve older patients with higher rates of chronic illness say the idea of pausing hiring is not theoretical; it means longer drives for dialysis, canceled specialty clinics, or more transfers for complex births. In border counties and agricultural regions, immigrant physicians also bring language skills and cultural competency that improve care for diverse populations. Losing those hires, administrators say, reduces adherence to treatment and worsens outcomes in chronic diseases such as diabetes and hypertension.

The policy shift has also sparked debate over the United States’ role as a destination for global medical talent. For decades, the H-1B route has been a key bridge for physicians who complete U.S. residencies or fellowships and then take up staff roles. Hospitals and universities say the pipeline has helped maintain a steady flow of specialists in fields with long training cycles. If that bridge becomes too costly to cross, they warn, candidates may choose health systems in other countries, creating a competitive disadvantage for U.S. research and clinical programs.

Clinicians and advocates are directing employers and prospective hires to official guidance while the debate unfolds. The USCIS H-1B specialty occupations page outlines eligibility, petition steps, and compliance obligations, and hospital HR departments say they are updating compliance trainings to reflect the new cost environment. Recruiters advise that any exemptions for healthcare, if adopted, would take time to translate into hiring, given the lead times for credentialing and state licensing.

For Anantha in Arkansas, the calculus is simple: hospitals count on immigrant physicians to keep cath labs, ICUs, and clinics running, and patients in his region cannot afford a pause. Mukkamala, speaking for the AMA, frames the moment as a stress test for a system already stretched thin:

“We have heard from health systems who say this fee would be devastating.”

Kathula, representing thousands of Indian-origin doctors, returns to the core function those clinicians perform every day—“filling critical gaps in care.” Their message, echoed by hospital groups and trainees, is that the H-1B fees decision is not an abstract budget issue, but a choice with direct consequences for patients, especially in the parts of America where the next doctor is already hours away.